骨松康复汤治疗肾虚血瘀型原发性骨质疏松症的临床观察

发布时间：2018-04-22 03:42

本文选题：原发性骨质疏松症 + 肾虚血瘀　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:通过观察骨松康复汤治疗肾虚血瘀型原发性骨质疏松症的临床疗效,系统评价其有效性和安全性,为祖国医学防治该病提供行之有效的治疗方法。方法:选取符合纳入标准的原发性骨质疏松症患者60例,采用随机数字表法分为试验组(骨松康复汤组)30例,对照组(骨疏康颗粒组)30例。两组均服药1个月为一疗程,共服3个疗程。通过分别记录治疗前、治疗1、2个月后的中医症候积分、腰背疼痛VAS评分和记录治疗前、治疗3月后的骨密度、相关生化指标(ALP、S-Ca、S-P值)、安全性指标的数据,将所有研究数据纳入SPSS22.0软件进行统计分析,综合评定其疗效。结果:(1)骨松康复汤在治疗1个月后的腰背疼痛VAS评分、在治疗2个月后的中医症候积分与骨疏康颗粒相比较,有统计学意义(P0.05),存在显著性差异。(2)两组患者通过治疗1个月后组间各项中医症候对比,发现治疗1个月后试验组在腰脊刺痛、步履艰难两个方面较对照组,有统计学意义(P0.05),存在显著性差异;其余各项无统计学意义(P0.05),不存在显著性差异。(3)两组患者通过治疗2个月后组间各项中医症候对比,在腰脊刺痛、腰膝酸软、痛处固定、下肢痿弱、步履艰难、头晕耳鸣六方面均存在显著性差异(P0.05),说明骨松康复汤在上述六方面优于骨疏康颗粒。(4)中医症候疗效比较:经秩和检验,Z=-1.067,P=0.2860.05,无统计学意义,说明两组治疗2个月后比较总有效率无显著性差异;但在控制显效率上试验组(62.07%)高于对照组(46.43%)。(5)腰背疼痛疗效比较:经秩和检验,Z=-1.018,P=0.3090.05,无统计学意义。(6)骨密度值方面比较:两组患者治疗前后比较和治疗3个月后组间比较,均经统计学处理,P0.05,表明均无统计学意义,不存在显著性差异。(7)两组患者碱性磷酸酶值治疗前后比较和治疗3个月后组间比较,经统计学处理,P0.05,无统计学意义,不存在显著性差异。(8)两组患者血清钙离子、血清磷离子治疗前后行组内比较和治疗3个月后组间比较,经统计学处理,P0.05,均无统计学意义,不存在显著性差异。结论:骨松康复汤和骨疏康颗粒在肾虚血瘀型原发性骨质疏松症患者治疗方面均有明显治疗效果。骨松康复汤和骨疏康颗粒均未能使POP患者腰2-4椎体、股骨大粗隆骨密度值、ALP、S-Ca及S-P值发生明显变化,但骨松康复汤和骨疏康颗粒均能有效改善肾虚血瘀型POP患者的临床症状,且具有疗效肯定、无不良反应及无副作用特点。尤其骨松康复汤在改善腰脊刺痛、腰膝酸软、痛处固定、下肢痿弱、步履艰难、头晕耳鸣等中医临床症候方面较骨疏康颗粒优势明显。
[Abstract]:Objective: to evaluate the efficacy and safety of Guzongkoutang in the treatment of primary osteoporosis with kidney deficiency and blood stasis, and to provide an effective treatment method for the prevention and treatment of the disease in traditional Chinese medicine. Methods: sixty patients with primary osteoporosis were selected and randomly divided into experimental group (30 cases) and control group (30 cases). Both groups took medicine for one month as a course of treatment, a total of 3 courses of treatment. The scores of TCM symptoms before treatment, 1 month and 2 months after treatment, VAS score of lumbar and back pain, bone mineral density (BMD) before treatment and 3 months after treatment were recorded, and the data of ALPS-CaS-P and safety index were recorded. All the research data were analyzed by SPSS22.0 software, and the curative effect was evaluated synthetically. Results one month after treatment, the VAS score of the pain in the back of the waist and the symptom score of traditional Chinese medicine after 2 months of treatment were compared with those of the Gushukang granules. There was a significant difference between the two groups after one month of treatment. It was found that after one month treatment, the experimental group had more pain in lumbar spine and more difficult walking than the control group. There was significant difference between the two groups (P 0.05), the other items were not statistically significant (P 0.05), there was no significant difference between the two groups after 2 months of treatment, the symptoms of TCM were compared between the two groups, and the pain was stinging at the lumbar spine, the waist and knee were sore, and the pain was fixed at the place where the pain was fixed. There was a significant difference in the six aspects of dizziness and tinnitus (P 0.05), which indicated that Gusong Kang Tang was better than Gushukang granule. 4) the curative effect of traditional Chinese medicine syndrome was better than that of Gushukang granules. The rank sum test showed that there was no significant difference between the two groups, and there was no significant difference between them by rank sum test. There was no significant difference in the total effective rate between the two groups after 2 months of treatment. But the effective rate of control in experimental group (62.07) was higher than that in control group (46.43) compared with that in control group (46.43). Comparison of the effects of lumbar and back pain: comparison of bone mineral density between the two groups before and after treatment and after 3 months of treatment by rank sum test: the bone mineral density was 0.3090.05 with no statistical significance. There was no significant difference in alkaline phosphatase value between the two groups before and after treatment, and there was no significant difference between the two groups after 3 months of treatment, and there was no significant difference between the two groups after statistical treatment (P 0.05). There was no significant difference between the two groups. There was no significant difference in serum calcium between the two groups. There was no significant difference between the two groups before and after the treatment and after 3 months of treatment, there was no significant difference between the two groups (P 0.05). Conclusion: Gusongkang decoction and Gushukang granule have obvious therapeutic effect on primary osteoporosis of kidney deficiency and blood stasis type. Both Guzongkangtang and Gushukang granules could not make the lumbar 2-4 vertebrae of POP patients, and the bone mineral density of the great trochanter of femur had obvious changes in ALPS-Ca and S-P values, but both of them could effectively improve the clinical symptoms of POP patients with kidney deficiency and blood stasis type. And it has definite curative effect, no side effect and no side effect. Especially in improving lumbar spine pain, lumbar knee pain, pain fixation, lower limb impotence, treadmill difficult, dizziness tinnitus and other TCM clinical symptoms than the advantages of Gushukang granules.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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